Pediatric emergency care
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Our objective was to describe young children injured through the use of infant carrier car seats, comparing them with children injured through other fall mechanisms. ⋯ Falls from infant carriers are common, often involve children unbuckled in their car seats, and represent a significant source of morbidity. Injury prevention measures such as education and manufacture labeling may be effective strategies.
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Pediatric emergency care · Feb 2009
Review Case ReportsAccidental methadone ingestion in an infant: case report and review of the literature.
We discuss accidental methadone intoxication in an 11-month-old female infant, review the literature, and stress the potential for child abuse among methadone-maintained caregivers. ⋯ Methadone intoxication should be considered in children presenting with lethargy, miosis, and respiratory depression. Seventy-two percent of reported methadone poisoning patients are symptomatic, and unintentional poisoning is a real danger to children because small amounts can be fatal. There are also several case reports where the cause of intoxication was homicide by the parents. Initial management consists of establishing an airway, and naloxone may be indicated, before urine toxicology results are obtained, to help establish the diagnosis. However, if 2 doses do not reverse the child's symptoms, the diagnosis should be questioned. When repeated bolus doses of naloxone are indicated, a continuous infusion may be preferable.
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Pediatric emergency care · Feb 2009
Multicenter StudyEmergency management of pediatric convulsive status epilepticus: a multicenter study of 542 patients.
To perform a multicenter study examining the presentations and emergency management of children with convulsive status epilepticus (CSE) to sites within the Paediatric Research in Emergency Departments International Collaborative. ⋯ Convulsive status epilepticus is an important neurological emergency, with many children experiencing prolonged seizures in both the prehospital and hospital phases. Persistent seizure activity beyond 40 minutes contrasts with current published guidelines. There is a need to adopt a widely accepted approach to the management of children who fail to respond to standard anticonvulsant therapy.
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Pediatric emergency care · Feb 2009
Case ReportsProlonged toxicity in a 2-year-old after accidental ingestion of aripiprazole.
Aripiprazole (Abilify), or 7-{4-[4-(2,3-dichlorophenyl)-1-piperazinyl]butyloxy}-3,4-dihydro-2(1H)-quinolone, is a novel atypical antipsychotic possessing a long half-life. Although not a Food and Drug Administration-approved indication, low-dose aripiprazole is used to treat pediatric psychiatric conditions. ⋯ She exhibited marked lethargy, tremor, and tachycardia persisting over 72 hours. Emergency physicians, pediatricians, and psychiatrists should be aware of the potential for significant and prolonged toxicity in children even with relatively small-dose aripiprazole exposures.
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Pediatric emergency care · Feb 2009
Enema-reduced intussusception management: is hospitalization necessary?
To describe the demographic and clinical characteristics of hospitalized children with enema-reduced intussusception and to determine the necessity of hospitalization. ⋯ Hospitalized children with enema-reduced intussusception required minimal interventions, had a low rate of signs and symptoms requiring further radiographic studies, and had no enema-reduced serious complications during hospitalization. These results support outpatient management as an acceptable alternative.